
Course Introduction
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Course Introduction
Nursing Pharmacology introduces students to the foundational principles of pharmacology with a focus on drugs commonly used in clinical nursing practice. This course explores pharmacokinetics, pharmacodynamics, drug classifications, mechanisms of action, adverse effects, and safe medication administration. Students will learn to apply critical thinking in making clinical decisions regarding pharmacological interventions and consider factors influencing drug therapy, including age, comorbidities, and cultural differences. Emphasis is placed on patient education, prevention of medication errors, and collaboration within the healthcare team to ensure optimal patient outcomes.
Recommended Textbook
Basic Pharmacology for Nurses 16th Edition by Clayton
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50 Chapters
994 Verified Questions
994 Flashcards
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Sample Questions
Q1) Which statement is true about over the counter (OTC) drugs?
A)They are not listed in the USP NF.
B)A prescription from a health care provider is needed.
C)They are sold without a prescription.
D)They are known only by their brand names.
Answer: C
Q2) Which source contains information specific to nutritional supplements?
A)USP Dictionary of USAN & International Drug Names
B)Natural Medicines Comprehensive Database
C)United States Pharmacopoeia/National Formulary (USP NF)
D)Drug Interaction Facts
Answer: C
Q3) Meperidine (Demerol) is a narcotic with a high potential for physical and psychological dependency.Under which classification does this drug fall?

D)IV
Answer: B
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Sample Questions
Q1) Which factor(s) affect(s) drug actions? (Select all that apply.)
A)Teratogenicity
B)Age
C)Body weight
D)Metabolic rate
E)Illness
Answer: B, C, D, E
Q2) Which are routes of drug excretion? (Select all that apply.)
A)GI tract; feces
B)Genitourinary (GU) tract; urine
C)Lymphatic system
D)Circulatory system; blood/plasma
E)Respiratory system; exhalation
Answer: A, B, E
Q3) Which is the best description of when drug interactions occur?
A)On administration of toxic dosages of a drug
B)On an increase in the pharmacodynamics of bound drugs
C)On the alteration of the effect of one drug by another drug
D)On increase of drug excretion
Answer: C

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Q1) Which patient would the nurse identify as having the lowest rate of absorption of enteral medications?
A)A 5-year-old boy
B)An 18-year-old woman
C)A 55-year-old man
D)An 85-year-old woman
Answer: A
Q2) When is the ideal time for a nursing mother to take her own medications?
A)Before the infant latches on to begin to breastfeed
B)As soon as the mother wakes up in the morning
C)Right before the mother goes to sleep at night
D)As soon as the infant finishes breastfeeding
Answer: D
Q3) Which classification of medications commonly causes allergic reactions in children?
A)Antacids
B)Analgesics
C)Antibiotics
D)Anticonvulsants
Answer: C
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Q1) What is the primary purpose of the nursing assessment?
A)Identifying underlying pathologic conditions
B)Assisting the physician in identifying medical conditions
C)Determining the patient's mental status
D)Exploring patient responses to health problems
Q2) Which statement best describes the planning phase of the nursing process?
A)Administer insulin subcutaneously (subcut) in the abdominal area.
B)Patient is at high risk for falls related to hypotension.
C)The patient will state the expected adverse effects of medication by the end of the teaching session.
D)Itching has resolved; medication given is effective.
Q3) What is the basis of the NANDA I taxonomy?
A)Functional health patterns
B)Human response patterns
C)Basic human needs
D)Pathophysiologic needs
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Q1) Which represents the psychomotor domain of learning?
A)The patient draws up insulin in a syringe.
B)The patient expresses a belief about medication use.
C)The patient is able to verbalize foods that should be avoided.
D)The patient relates past experience with smoking cessation.
Q2) Which would positively affect readiness to learn?
A)Fear and denial
B)Willingness to attain an optimal level of health
C)Poor cognitive and motor development
D)Lack of trust and confidence in the staff
Q3) Which item(s) would be considered characteristic of the cognitive domain level of learning? (Select all that apply.)
A)A patient's opinion regarding wellness
B)Basic mathematical formulas learned in grade school
C)Incorporation of a person's previous experiences and perceptions
D)Skill demonstration using a step by step approach
E)Relationship between prior experiences and new concepts
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Sample Questions
Q1) 0.00007 = _____
Q2) 0.6 ÷ 2 = _____
Q3) 10,000 * 0.75 = _____
Q4) 1:45 = _____ (%), _____ (fraction), _____ (decimal [round to the nearest thousandth])
Q5) 10 7/9 - 6 1/6 = _____
Q6) 1/2 * 1/3 = _____
Q7) 1000 mL of solution containing 50 g glucose in water: _____
Q8) What is the most accurate way for the nurse to document the administration of two milligrams of a medication?
A) Two mg
B) 2.0 mg
C) 2 mg
D) II mg
Q9) 0.25 * 1/2 = _____
Q10) Convert 2 tsp to milliliters (mL): _____
Q11) 1 3/4 = _____
Q12) 500 mL of solution containing 350 mL alcohol in water: _____ Page 8
Q13) 5/12 * 3/4 = _____
Q14) 2 1/2 + 1 1/3 = _____
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Q1) Which statement(s) is/are true regarding computerized prescriber order entry (CPOE)? (Select all that apply.)
A)Integrates the ordering system with the pharmacy, laboratory, and nurses' stations
B)Provides instant access to online information to facilitate patient care needs
C)Facilitates review of ordered medications for potential drug interactions
D)Facilitates review of drugs for appropriateness of dosages
E)Alleviates the need to perform mathematical computations
Q2) Which statement(s) is/are true regarding the types of medication orders? (Select all that apply.)
A)Stat orders are the same as single dose orders.
B)Standing orders indicate the number of specified doses of a medication to be given.
C)Renewal orders facilitate physician review before continuance of high risk medications.
D)PRN medications will designate a mandatory number of times the medication is to be administered.
E)Verbal orders should be used as much as possible.
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Sample Questions
Q1) Which action will the nurse perform when doing a wet to dry dressing every 4 hours on a patient with a deep wound?
A)Pack the wound tightly with gauze.
B)Saturate the dressing with as much liquid as possible.
C)Use Montgomery tapes or a binder to secure the dressing.
D)Apply the new moist dressing over the existing one.
Q2) Which medications must be sterile?
A)Topical
B)Vaginal
C)Ophthalmic
D)Nasal
Q3) What is the rationale for the nurse applying gentle pressure to the inner corner of the eyelid after instilling eye drops?
A)Decreases the risk of infection
B)Maintains intraocular pressure
C)Prevents systemic effects
D)Provides comfort to the patient
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Q1) Which action by the nurse is appropriate when administering enteric coated tablets?
A)Administer with an antacid.
B)Crush the tablet and mix with applesauce.
C)Encourage the patient to drink a full glass of water.
D)Instruct the patient to place the medication between the cheek and teeth.
Q2) The nurse is administering an oral medication to a 90 year old patient who has difficulty swallowing pills.One of the medications to be administered is a spansule type capsule.What nursing consideration(s) should be applied in this case? (Select all that apply.)
A)Wash hands before preparing medications and before administration.
B)Crush medications and administer with a soft food, such as applesauce.
C)Check the patient's ID band with the MAR to ensure patient rights are followed.
D)Have an 8 ounce glass of water available.
E)Check with the pharmacist to see if the spansule medication comes in a liquid form.
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Q1) Which principle(s) is/are correct for mixing insulin? (Select all that apply.)
A)Insulin orders and calculations must be checked with another nurse.
B)Air is injected into the vial of the shorter acting insulin first.
C)The longer acting insulin is drawn up first.
D)The nurse must verify the compatibility of the insulin types.
E)Withdraw the shorter acting insulin first.
Q2) The operating room (OR) nurse is preparing medications for use in a sterile field during a surgical procedure.While preparing these medications, the nurse will:
A)save unused portions of medication for use in another procedure.
B)differentiate between sterile and nonsterile medications to be used in the OR.
C)ensure the scrub (sterile) nurse retrieves the medication from storage.
D)read the label aloud for verification against the order from the surgeon.
Q3) Which action by the nurse is accurate when withdrawing medication into a syringe from a vial?
A)Inject an amount of air equal to the medication into the vial.
B)Break the thin neck of the vial container.
C)Remove the rubber stopper on the top of the vial.
D)Discard the initial 0.5 mL of medication to ensure sterility.
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Sample Questions
Q1) The vastus lateralis muscle is appropriate for injections for which patient(s)? (Select all that apply.)
A)Children younger than 3 years of age
B)Elderly
C)Debilitated
D)Nonambulatory
E)Ambulatory
F)Healthy
Q2) Which nursing action is accurate when administering an IM injection using the Z track method?
A)Use a 1-inch needle.
B)Add 0.5 mL of air to the syringe.
C)Vigorously massage the injection site.
D)Pinch up the skin.
Q3) Which site is identified by the posterior superior iliac spine and greater trochanter?
A)Ventrogluteal
B)Dorsogluteal
C)Vastus lateralis
D)Rectus femoris

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Q1) The nurse notes that a patient with cardiac disease has IV heparin infusing and that it is behind by 2 hours.What is the best nursing action?
A)Increase the IV rate and recheck in 1 hour.
B)Change the infusion rate to TKO.
C)Discontinue the solution using aseptic technique.
D)Contact the health care provider for consultation.
Q2) A patient is admitted with hypovolemia resulting from lack of fluid intake and requires an infusion of isotonic fluids.Which IV solution will the nurse administer?
A)D<sub>5</sub>0.2 NS
B)D<sub>5</sub>W
C)0.45 NS
D)0.9 NS
Q3) Which technique by the nurse accurately maintains asepsis of a peripheral IV access device?
A)Wear gloves when hanging all IV solutions.
B)Apply a topical antibiotic ointment to the insertion site.
C)Change fluid administration sets according to institutional policy.
D)Flush with heparin before use.
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Q1) What is the primary response to alpha 1 receptor stimulation?
A)Bronchodilation
B)Tachycardia
C)Vasoconstriction
D)Uterine relaxation
Q2) Which statement(s) is/are true about efferent nerves? (Select all that apply.)
A)They transmit signals to the spinal cord and brain.
B)They leave the CNS to carry impulses to other body parts.
C)They are part of the peripheral nervous system.
D)They transmit signals that control contractions of smooth and skeletal muscle.
E)They transmit signals that control contractions of some glandular secretions.
Q3) A patient with a history of type 1 diabetes after myocardial infarction has been placed on a beta adrenergic blocking agent.Which statement by the patient indicates a need for further teaching?
A)"This medication should not be discontinued suddenly."
B)"This medication lowers my blood pressure by helping me get rid of fluid."
C)"I may not have my usual symptoms of a hypoglycemic reaction while on this drug."
D)"This medication may take a few weeks to work."
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Q1) The nurse finds that a patient is extremely agitated, yells frequently, and is attempting to get out of bed without assistance.What is the nurse's initial action?
A)Administer zolpidem after taking the patient's vital signs.
B)Close the patient's door for privacy after administering Tylenol.
C)Administer benzodiazepine before calling the health care provider.
D)Spend uninterrupted time listening to the patient.
Q2) Why are benzodiazepines often preferred over barbiturates? (Select all that apply.)
A)They have selective action at specific receptor sites.
B)There is a wide range of safety between therapeutic and lethal levels.
C)REM sleep is decreased to a lesser extent.
D)Accidental overdoses are well tolerated.
E)There are no hypotensive episodes when rising to a sitting position.
Q3) Which sleep pattern stage diminishes as an effect of aging?
A)Stage I
B)Stage II
C)Stage III
D)Stage IV
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Q1) The nurse is assessing an older patient with Parkinson's disease who was started on entacapone 1 week ago.The patient has a history of coronary artery disease and takes an antihypertensive and aspirin.Which information would support the need for a reduction in medication dosage by the health care provider?
A)Constipation
B)Brownish orange urine
C)Drowsiness
D)Dizziness
Q2) The nurse is teaching a patient with Parkinson's disease about levodopa.Which statement by the nurse is accurate regarding drug administration?
A)"Take this medication in between meals."
B)"Take this medication at bedtime to prevent dizziness."
C)"Take this medication when your tremors get worse."
D)"Take this medication with food or antacids to reduce GI upset."
Q3) Which vitamin will reduce the therapeutic effects of levodopa?
A)A
B)B<sub>6</sub>
C)C D)D
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Q1) The nurse is preparing to educate a patient and significant other about antianxiety medications before the patient's discharge.What is pertinent information to be included in the teaching plan?
A)Discuss, review, and validate the behavior monitoring system and intervention flow sheet the patient and significant other will continue to use following discharge.
B)Discuss the possible dependence associated with the medication at length to make sure the patient does not overuse the drug.
C)Instruct the patient to educate family members about the medication therapy, based on recollection of discussions with the nurse.
D)Provide all instructions verbally, with repetition as needed when requested by the patient.
Q2) Which patient is most likely to respond quickly to antianxiety therapy with benzodiazepines?
A)Patient with a history of long-term anxiety
B)Patient with recent anxiety reactions
C)Patient with severe depression in addition to being anxious
D)Patient with incidents of auditory hallucinations
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Q1) Which assessment would the nurse expect to observe in a patient who has been prescribed trazodone for treatment anxiety?
A)Excessive thirst
B)Hand tremor
C)Drowsiness
D)Diarrhea
Q2) The nurse is preparing 0800 medications for a patient with the medical diagnosis of end stage renal disease.When reviewing the medication administration record (MAR), the nurse notices the patient is scheduled to receive an MAOI drug.Which intervention(s) will the nurse perform before administering the drug? (Select all that apply.)
A)Assess temperature.
B)Provide an alternative drug.
C)Hold the MAOI drug.
D)Consult with the prescribing health care provider.
E)Assess urine output prior to administration.
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Q1) What is the most common cause of nonadherence to antipsychotic pharmacologic treatment?
A)Expense
B)Increased symptoms of chemical dependency
C)Extrapyramidal effects
D)Inability of the patient to understand the need to take medications
Q2) A young male patient taking an antipsychotic is experiencing an oculogyric crisis.The nurse prepares to administer:
A)diphenhydramine.
B)haloperidol.
C)aripiprazole.
D)risperidone.
Q3) Which type of adverse effects is present when a patient displays prolonged tonic contractions of the tongue, oculogyric crisis, and torticollis?
A)Dystonic reactions
B)Pseudoparkinsonism
C)Akathisia
D)Tardive dyskinesia
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Q1) Which medication is used to control seizures or prevent migraine headaches?
A)Topiramate (Topamax)
B)Zonisamide (Zonegran)
C)Valproic acid (Depakene)
D)Tiagabine (Gabitril)
Q2) For which condition may carbamazepine (Tegretol) be used?
A)Tardive dyskinesia
B)Psychotic episodes
C)Trigeminal neuralgia pain
D)Sedation
Q3) What is included in the nursing management of the patient with generalized tonic clonic seizure activity? (Select all that apply.)
A)Restraining the patient's arms to avoid further injury
B)Placing padding around or under the patient's head
C)Attempting to insert a tongue depressor into the patient's mouth
D)Positioning the patient on the side once the relaxation stage is entered to allow oral secretions to drain
E)Requesting additional assistance and/or necessary equipment in case the patient does not begin breathing spontaneously when the seizure is over
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Q1) Which condition(s) may be managed by salicylates? (Select all that apply.)
A)Migraine headache
B)Swollen joints
C)Fever
D)Muscle aches
E)Myocardial infarction
Q2) When performing a baseline neurologic assessment prior to the administration of an NSAID medication, the nurse will assess which patient characteristic(s)? (Select all that apply.)
A)Vital signs
B)Orientation to date, time, and place
C)Mental alertness
D)Bowel sounds
E)Concurrent use of anticoagulant agents
Q3) In which case would the nurse be correct in withholding an opiate agonist?
A)Evidence of postural hypotension
B)Presence of constipation
C)Pain rating of 7 on a 0 to 10 scale
D)Respiratory rate of 10 breaths/min
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Q1) In addition to type 2 diabetes and heart disease, which condition(s) is/are associated with metabolic syndrome? (Select all that apply.)
A)Dementia
B)Insomnia
C)Renal disease
D)Obstructive sleep apnea
E)Orthostatic hypotension
F)Polycystic ovary syndrome
Q2) Weight: 140 pounds.Height: 5 feet 4 inches.What is the BMI?
Q3) What is the most critical approach to the treatment of metabolic syndrome?
A)Psychotherapy
B)Pharmacotherapy
C)Lifestyle management
D)Patient education
Q4) Weight: 70 kilograms.Height: 164 cm (1.65 m).What is the BMI?
Q5) What is the incidence of metabolic syndrome in the United States?
A)1 in 4000
B)1 in 400
C)1 in 40
D)1 in 4

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Q1) The nurse is preparing medications for a patient.When is the best time for the nurse to administer lovastatin (Mevacor)?
A)2 hours after breakfast
B)During the patient's dinner
C)1 hour before breakfast
D)30 minutes before lunch
Q2) Why are statins, or HMG CoA reductase inhibitors, administered at bedtime?
A)The stomach is empty.
B)Metabolic needs of the body are decreased.
C)Cholesterol production is at its peak.
D)The body temperature is increased.
Q3) The nurse transcribes a new order for Lovaza on a patient in a long term care facility.When providing education to the patient about this medication, the nurse will include which statement(s)? (Select all that apply.)
A)Liver function tests should be completed before initiating therapy.
B)Lovaza is available in tablet form.
C)Triglyceride levels should increase with use.
D)Lovaza should be used with caution if the patient has an allergy to fish.
E)Lovaza does not cause myositis.
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Q1) Which class of antihypertensive agents should be avoided by patients with asthma?
A)ACE inhibitors
B)Diuretics
C)Aldosterone receptor antagonists
D)Beta adrenergic blocking agents
Q2) Which common adverse effect of an angiotensin II receptor antagonist will the nurse expect to assess in a patient?
A)Bradycardia
B)Headache
C)Hypokalemia
D)Insomnia
Q3) Which complication(s) is/are associated with uncontrolled hypertension? (Select all that apply.)
A)Angina
B)Stroke
C)Hyperglycemia
D)Renal failure
E)Heart failure
Q4) If blood pressure is 120/70, what is the MAP?
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Q1) The nurse is preparing to administer adenosine to a patient with supraventricular tachycardia.Which consideration(s) should the nurse take into account before administration? (Select all that apply.)
A)Constant ECG monitoring is necessary.
B)Initial recommended dosage is 12 mg IV bolus.
C)Rapid IV bolus administration is recommended.
D)Saline flush following bolus is necessary.
E)Long half life of adenosine may prolong adverse medication effects.
Q2) A patient is admitted to the acute care telemetry unit with a diagnosis of atrial fibrillation.The physician orders dofetilide (Tikosyn).Before initiating this medication, the nurse will:
A)hold anticoagulant medications.
B)remove ECG leads.
C)assess potassium level.
D)ensure QTc interval is more than 440 to 500 msec.
Q3) Amiodarone is contraindicated for patients with which condition?
A)Pulmonary edema
B)Severe sinus node dysfunction causing bradycardia
C)Atrial fibrillation
D)Premature ventricular contractions (PVCs)
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Q1) A patient has been diagnosed with angina pectoris and an elevated LDL cholesterol level.The health care provider has prescribed HMG CoA reductase inhibitor.What is the primary indication in using this medication?
A)Reduce coronary vessel spasm.
B)Simplify oxygen requirements of the cardiac cells.
C)Lower cholesterol levels.
D)Dilate the coronary arteries.
Q2) Which statement about ranolazine (Ranexa), a fatty oxidase enzyme inhibitor, is true?
A)It causes coronary artery vasodilation.
B)It causes no gastrointestinal (GI) side effects.
C)It causes QT interval prolongation.
D)It elevates LDL levels.
Q3) What is the rationale behind administering calcium channel blockers to patients with angina?
A)They decrease heart rate.
B)They dilate blood vessels.
C)They increase cardiac contractility.
D)They promote fluid excretion.
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Q1) Which patient statement indicates to the nurse that the patient has a good understanding of PVD?
A)"Symptoms are warning signs of the increased potential to develop diseases."
B)"Pharmacologic treatments can reverse the disease process."
C)"Surgical interventions will cure the disease."
D)"Controlling contributing factors may affect the progression of the disease."
Q2) Which are necessary steps in the assessment of the patient preparing for treatment PVD with pentoxifylline (Trental)? (Select all that apply.)
A)Check for intolerance to caffeine.
B)Obtain baseline data on pain that may be present.
C)Obtain test results for PT and aPTT.
D)Perform baseline gastrointestinal assessment to determine if the patient has nausea, vomiting, or dyspepsia.
E)Ask specifically if the patient has any cardiac symptoms or dizziness.
F)Schedule the patient for an exercise stress test.
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Q1) A patient receiving IV heparin therapy for a deep vein thrombosis (DVT) in his right calf asks why his calf remains painful, edematous, and warm to touch after 2 days of anticoagulant therapy.Which response by the nurse is most accurate?
A)"It takes at least 3 days for the symptoms to resolve once the clot dissolves."
B)"Heparin does not dissolve blood clots, but neutralizes clotting factors, preventing extension of the clot and the possibility of it traveling elsewhere in your body."
C)"I will report this to your health care provider because there may be a need to look at alternative treatments."
D)"You appear anxious.The health care provider will eventually put you on ticlopidine, which allows for an earlier discharge."
Q2) Which is an accurate nursing action when administering subcutaneous enoxaparin, a low-molecular-weight heparin product?
A)Expel the air bubble from the prefilled syringe.
B)Leave the needle in place for 10 seconds after injection.
C)Administer the medication into the deltoid muscle.
D)Massage the site after injection to increase absorption.
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Q1) Which drug will be administered to a patient being admitted with severe digoxin intoxication?
A)Amiodarone (Cordarone)
B)Spironolactone (Aldactone)
C)Digoxin immune Fab (Digibind)
D)Digitalis glycoside
Q2) Which statements about vasodilators is/are true? (Select all that apply.)
A)They reduce systemic vascular resistance.
B)They increase afterload.
C)They reduce preload.
D)They decrease pulmonary congestion.
E)They increase tissue perfusion to muscles and organs.
F)They increase the volume of blood returning to the heart.
Q3) Which drug is used to obtain vasodilation in the treatment of chronic heart failure?
A)ACTH
B)ACE inhibitors
C)ARBs
D)ANB agents
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Q1) A patient who has heart failure and difficulty breathing is being admitted.Which physical assessment(s) indicate(s) fluid volume excess? (Select all that apply.)
A)Rapid, bounding, irregular pulse rate
B)Clear lung sounds
C)3+ pitting ankle edema
D)Neck vein engorgement
E)Shortness of breath
Q2) Individuals with which disorder(s) are particularly susceptible to the development of electrolyte disturbances during diuretic therapy? (Select all that apply.)
A)History of cardiac disease
B)History of renal disease
C)History of hormonal disorders
D)History of psychiatric illness
E)Massive trauma
F)Serious burns
G)Overhydration
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Q1) A patient at sports camp is complaining of itchy and watery eyes, coughing, and sneezing when outdoors.The patient's chart states that he has an allergy to grasses.Which medication will the nurse administer?
A)Antitussive
B)Expectorant
C)Antihistamine
D)Decongestant
Q2) Which instruction will the nurse include when teaching a patient with seasonal rhinitis and blocked nasal passages about intranasal corticosteroid therapy?
A)"Clear your nasal passage after administration."
B)"Anticipate a therapeutic benefit within 24 hours."
C)"Use a decongestant prior to administration."
D)"Report nasal burning to your health care provider."
Q3) What occurs in the nasal structures when cholinergic fibers are stimulated?
A)Dryness of mucous membranes in the nostrils
B)Bleeding in the mucous membranes in the nostrils
C)Production of serous and mucous secretions in the nostrils
D)Enhanced olfactory perception in the mucous membranes of the nostrils
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Q1) Which statement(s) is/are true regarding the nursing assessment of a patient with a respiratory disorder? (Select all that apply.)
A)Central cyanosis typically is observed on the fingers and earlobes.
B)Clubbing of the fingernails is a sign of hypoxia.
C)As oxygen levels diminish, mental alertness will progressively deteriorate.
D)The normal respiratory rate in an adult is 10 breaths/min.
E)Episodes of apnea are present in Cheyne-Stokes.
Q2) What is the reason for administering potassium iodide to a patient with emphysema?
A)To increase blood iodide levels
B)To decrease mucus viscosity
C)To reduce metabolic needs of the body
D)To decrease bronchial irritation
Q3) From where do the fluids of the respiratory tract originate?
A)Specialized mucous glands called goblet cells
B)Lymph fluid drawn across nasal membranes by osmosis
C)Specialized beta cells in the islets of Langerhans
D)Cells that produce aqueous humor
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Q1) Which infection is often called the "disease of the diseased" because it appears in debilitated patients?
A)Aspergillosis
B)Candidiasis
C)Trichomoniasis
D)Brucellosis
Q2) A patient who is undergoing bone marrow transplantation has developed severe mucositis.Which treatment option(s) may promote comfort? (Select all that apply.)
A)2% viscous lidocaine (Xylocaine) before meals
B)Acetylcysteine (Mucomyst) therapy as needed
C)Commercially prepared mouthwashes
D)Docosanol (Abreva) therapy
E)Milk of Magnesia mouth rinses
Q3) Which condition is treated by saliva substitutes?
A)Caries
B)Mucositis
C)Xerostomia
D)Halitosis
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Q1) Which explanation by the nurse is accurate to include when teaching a patient who is beginning therapy for gastroesophageal reflux disease (GERD) with metoclopramide?
A)"This medication decreases esophageal muscle tone to reduce reflux."
B)"Peristalsis is increased, so food is digested more quickly."
C)"Gastric emptying is delayed, so you may feel full for longer intervals."
D)"This medication is an antikinetic agent, so you may have difficulty with motor skills."
Q2) The nurse is discussing dietary and lifestyle changes with a patient diagnosed with GERD.When reviewing necessary modifications, the nurse will include information regarding: (Select all that apply.)
A)limiting coffee intake to 2 cups/day.
B)smoking cessation.
C)avoiding NSAIDs.
D)decreasing protein foods.
E)using nonfat milk
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Q1) Which herb has been used in many cultures to provide relief of nausea associated with pregnancy?
A)Mint
B)Hyssop
C)Echinacea
D)Ginger
Q2) A patient is beginning the second round of high dose cisplatin.Severe, chemotherapy induced nausea and vomiting (CINV) occurred following the first treatment, requiring 72 hours of continuous IV hydration.In addition to her chemotherapy regimen, which medication would be best to administer?
A)Prochlorperazine (Compazine) suppository daily, on the day of treatment and the next 3 days
B)Anticholinergic agents, such as diphenhydramine or meclizine
C)Parenteral ondansetron 1 hour before chemotherapy, with oral ondansetron to continue for the next 4 days
D)Parenteral ondansetron during chemotherapy, with prochlorperazine suppositories daily for 1 week
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Q1) An older adult is admitted through the emergency department with complaints of nausea, abdominal tenderness, and continual stooling.On assessment, the nurse notes abdominal distention, smearing of stool on undergarments, and hypoactive bowel sounds LUQ and LLQ.The patient is unable to determine when the last bowel movement was.What is the nurse's priority assessment?
A)Signs and symptoms of an infection
B)An impaction
C)A pattern of laxative abuse
D)History of GI disease
Q2) When the nurse assesses bowel habits in a patient, which is the best example of normal bowel elimination?
A)Daily bowel movements
B)Multiple soft stools daily
C)Daily liquid stools
D)Regular bowel elimination pattern of soft stool
Q3) What is the mechanism of action of a stimulant laxative?
A)Draws water into the bowel to facilitate the passage of feces
B)Lubricates the intestinal wall and soften stool
C)Increases bulk and stimulate peristalsis
D)Irritates the intestine directly, promoting peristalsis and evacuation
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Q1) The nurse is caring for a patient with a new diagnosis of type 1 diabetes mellitus.When assisting with the plan of care, which goal set by the patient will require revision?
A)Patient will participate in 20 minutes of cardiovascular exercise 5 days a week.
B)Patient will discontinue insulin use within 1 year.
C)Patient will consume 20% of caloric intake from fat.
D)Patient will demonstrate accurate self glucose testing skills.
Q2) After a blood glucose reading, it is determined that the patient should receive 4 units of Lispro and 8 units of NPH.Which action will the nurse take to administer these medications?
A)Draw up each insulin in separate syringes and administer two injections.
B)Draw up the NPH first and then the Lispro using the same syringe.
C)Administer the Lispro before the meal and the NPH after the meal.
D)Draw up the Lispro first and then the NPH using the same syringe.
Q3) When is the best time for the nurse to administer Lispro?
A)After the patient has started eating
B)Within 10 to 15 minutes of eating
C)30 minutes before a meal
D)45 to 60 minutes before a meal
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Q1) Which condition can occur if congenital hypothyroidism is not treated?
A)Diabetes
B)Impaired vision
C)Periorbital edema
D)Cretinism
Q2) A patient recently completed radiation treatment for throat cancer and presents to the health care provider's office with symptoms indicating possible hypothyroidism.Which symptom(s) would most likely be exhibited and/or reported? (Select all that apply.)
A)Inability to sleep
B)Weight gain
C)Lethargy
D)Nervousness
E)Cold intolerance
Q3) Which medication is used to treat hyperthyroidism?
A)Levothyroxine (Synthroid)
B)Liotrix (Thyrolar)
C)Propylthiouracil (Propacil)
D)Liothyronine (Cytomel)
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Q1) Which measure(s) for monitoring hydration and fluid balance would be inappropriate for the patient on steroid therapy? (Select all that apply.)
A)Daily weights
B)Abdominal girth measurements
C)Reports of thirst
D)Neurologic assessment
E)Assessment for alteration in skin integrity
Q2) Which statement(s) made by a patient on a corticosteroid medication show(s) a need for further education?
A)"I should increase my potassium intake."
B)"I may have to decrease my fluid intake."
C)"I will avoid weight bearing measures."
D)"I will change position frequently."
Q3) Which fluid replacement method will the nurse identify for a patient on a fluid restriction?
A)Freely throughout the day and evening shift
B)One third of the allowed volume on each shift
C)Half the volume with meals and the remainder divided among shifts
D)As the patient desires
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Q1) The health of a patient receiving androgen therapy for breast cancer declines and she becomes bed bound.Which condition will this patient be at risk of developing?
A)Electrolyte imbalances
B)Hypercalcemia
C)Hyperglycemia
D)Fluid overload
Q2) Which condition(s) would be of special concern when evaluating a patient for treatment with gonadal hormones? (Select all that apply.)
A)Sexually transmitted disease
B)Hypertension
C)Liver disease
D)Cancer of the reproductive organs
E)Smoking
Q3) Which is the most potent of the natural estrogenic hormones produced in the ovaries?
A)Estradiol
B)Estrone
C)Estriol
D)Estrogen
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Q1) What will the nurse include when teaching a postpartum patient about expected adverse effects of Rh<sub>o</sub>(D) immune globulin? (Select all that apply.)
A)Nausea
B)Constipation
C)Fever
D)Insomnia
E)Aches
F)Diarrhea
G)Anorexia
Q2) A patient is a gravida 1, Rh-negative woman at a 28 weeks' gestation.The father of her child is Rh positive.The mother is asking the nurse about the effect on her unborn child of RhoGAM that has been ordered.What is the nurse's best reply?
A)"Your child will do well after birth once transfusions are administered."
B)"If the baby is Rh negative at birth, he or she will need RhoGAM also."
C)"RhoGAM kills antibodies you make, so your child will be protected."
D)"Your baby may be Rh positive and cause you to make antibodies.These won't affect this baby, but could affect future children if RhoGAM isn't given."
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Q1) The nurse is obtaining a history on a patient who is seeking oral contraceptives.Which condition would contraindicate the use of oral contraceptives?
A)Sexually transmitted diseases (STDs)
B)Hypothyroidism
C)Varicose veins
D)Thromboembolic disease
Q2) A woman using the NuvaRing vaginal ring informs the nurse that the ring was accidentally expelled a day ago.The nurse will instruct this patient to:
A)rinse the ring in cool water and reinsert as soon as possible.
B)rinse the ring in hot water and reinsert as soon as possible.
C)rinse the ring in lukewarm water, reinsert, and use a nonhormonal back up contraceptive.
D)insert a new ring.
Q3) Which type of drug is most effective in the treatment of erectile dysfunction (ED)?
A)Phosphodiesterase inhibitors
B)Antiandrogen agents
C)Sympathomimetic agents
D)Alpha<sub>1</sub> adrenergic blocking agents
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Q1) How often is fosfomycin (Monurol) usually administered when used in the treatment of UTIs?
A)In a one-time dose
B)Once per day
C)Once per week
D)Monthly
Q2) A 14-year-old male is taking tolterodine (Detrol).What is the action of this drug?
A)Restores bladder tone and function
B)Decreases the urge to void
C)Prevents urinary retention
D)Acidifies urine
Q3) The nurse is reviewing the urinalysis results of an older adult patient admitted with elevated temperature and incontinence.Which urinalysis properties are indicative of an infection? (Select all that apply.)
A)Straw color
B)Foul odor
C)Trace glucose
D)pH of 8.2
E)Specific gravity of 1.014
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Q1) The nurse is preparing a patient for an ophthalmic examination.Which action occurs when the nurse instills eye drops to produce mydriasis?
A)Drying of tears in the eyes
B)Extreme dilation of the pupil
C)Opening of the canal of Schlemm
D)Paralysis of the ciliary muscle
Q2) Which statement(s) about aqueous humor is/are true? (Select all that apply.)
A)Bathes and feeds the lens, posterior surface of the cornea, and iris
B)Maintains the iris color
C)Drains out of the eye through drainage channels located near the junction of the cornea and sclera
D)Manufactures fluid for tear production
E)Flows out of the canal of Schlemm into the venous system of the eye
Q3) Which type of medication would be used to dilate the pupils before an eye examination?
A)Osmotics
B)Adrenergic agent
C)Beta adrenergic agent
D)Corticosteroid

Page 46
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Q1) The nurse is preparing to administer medroxyprogesterone acetate as prescribed to a patient diagnosed with endometrial carcinoma.When gathering supplies to provide this medication, the nurse will obtain a(n):
A)plastic medication cup.
B)medicine dropper.
C)subcutaneous needle and syringe.
D)intramuscular (IM) needle and syringe.
Q2) What is the intended outcome of the chemoprotective drug amifostine (Ethyol)?
A)Decreased nausea and vomiting
B)Increased effectiveness of the chemotherapy
C)Maintenance of body weight
D)Decreased renal toxicity
Q3) Which assessment by the nurse would be a sign of neurotoxicity related to chemotherapy?
A)Paresthesia
B)Euphoria
C)Nausea
D)Hallucinations
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Q1) A patient taking a neuromuscular blocking agent is assessed to have a heart rate of 120 and blood pressure of 80/50.The nurse will anticipate the physician writing an order for:
A)ABGs.
B)blood glucose level.
C)CBC.
D)liver function tests.
Q2) A patient taking antipsychotic medication for schizophrenia is admitted with a temperature of 106° F.The admitting diagnosis is neuroleptic malignant syndrome resulting from antipsychotic medication.Which drug is indicated in treatment of this condition?
A)Edrophonium (Tensilon)
B)Dantrolene (Dantrium)
C)Baclofen (Lioresal)
D)Metaxalone (Skelaxin)
Q3) Which common adverse effects occur with neuromuscular-blocking agents?
A)Fever
B)Flushing
C)Nausea
D)Ataxia
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Q1) The health care provider has prescribed penicillin and probenecid for a patient with a sexually transmitted disease.What is the purpose of combining these medications?
A)To accelerate the excretion of the penicillin
B)To inhibit the absorption of penicillin to allow the drug to remain in the transport phase
C)To inhibit the excretion of the penicillin
D)To reduce toxic effects associated with penicillin
Q2) The nurse is planning to administer ertapenem IV to a patient in the intensive care unit.When preparing this medication, the nurse will consider reconstituting it with: (Select all that apply.)
A)water.
B)bacteriostatic water.
C)0.9% sodium chloride.
D)0.45% dextrose.
E)1% lidocaine.
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Q1) A patient is being discharged on psyllium (Metamucil).Which explanation(s) by the nurse would be accurate regarding fiber intake? (Select all that apply.)
A)It adds bulk to fecal content.
B)It enhances gastric emptying.
C)It decreases blood cholesterol concentration.
D)It decreases postprandial blood glucose concentration.
E)It stimulates the appetite.
Q2) A patient who is 8 weeks' postpartum would like to begin a moderate intensity exercise program to lose the remaining 20 lb she gained during her pregnancy.Which exercise regimen will the nurse recommend to accomplish this goal best?
A)Walking 2 miles daily in 1 hour, four times weekly
B)Jogging 4 miles in 20 minutes, three times weekly
C)Walking 4 miles in 1 hour daily
D)Jogging 2 miles in 20 minutes, twice weekly
Q3) Which food is a good source of vitamin A?
A)Sweet potatoes
B)Apples
C)Bananas
D)Whole grain bread
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Q1) Which symptom(s) would be consistent with a paradoxical response associated with melatonin use? (Select all that apply.)
A)Drowsiness
B)Agitation
C)Insomnia
D)Poor concentration
E)Jet lag
Q2) The nurse is caring for a 36 year old male patient newly diagnosed with multiple sclerosis (MS).The patient asks if he can continue to take echinacea to help boost his immune system.The nurse's best response is:
A)"Limit use to no more than 8 weeks at a time"
B)"Echinacea use is not recommended for patients with autoimmune diseases"
C)"What other medications are you taking?"
D)"That is a decision that you will need to make independently"
Q3) Which statement about dietary supplements is true?
A)Dietary supplements are considered safe and effective.
B)Dietary supplements have not been tested for safety or efficacy.
C)There are no serious adverse effects to taking dietary supplements.
D)Dietary supplements have full FDA and USP approval.
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Q1) What important point(s) of patient education should be included about disulfiram (Antabuse) therapy? (Select all that apply.)
A)The patient should return for liver function tests in 10 to 14 days following initiation of therapy.
B)Headache, fatigue, and a metallic taste are common adverse effects that usually resolve.
C)Avoid alcohol ingestion to prevent a reaction.
D)Carefully read all labels for possible alcohol content, including perfumes, and over the counter (OTC) medications such as cough syrups.
E)Report to the health care provider any allergic symptoms, such as hives or pruritus.
Q2) Which theory views addiction as a maladaptive habit that can be examined and changed the same way as other habits?
A)Psychoanalytic theory
B)Behavior theory
C)Cognitive theory
D)Family system theory
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Q1) The nurse is caring for a patient diagnosed with gout who has elevated uric acid levels.Which medication will likely be administered?
A)Allopurinol (Zyloprim)
B)Disulfiram (Antabuse)
C)Lactulose (Cephulac)
D)Memantine (Namenda)
Q2) What is the mechanism of action of memantine (Namenda)?
A)Increases production of dopamine
B)Decreases production of serotonin
C)Blocks N-methyl-D-aspartate (NMDA) receptors in the central nervous system (CNS)
D)Enhances reuptake of central neurotransmitters
Q3) The nurse is caring for a patient with a new prescription for donepezil (Aricept) for symptoms of mild dementia.Which symptom exhibited by the patient should the nurse report to the physician immediately?
A)Bradycardia
B)Vomiting
C)Diarrhea
D)Dyspepsia
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